Painful Boney Metastases.
10.3344/kjp.2013.26.3.223
- Author:
Howard S SMITH
1
;
Intikhab MOHSIN
Author Information
1. Department of Anesthesiology, Albany Medical College, Albany, New York, USA. MohsinI@mail.amc.edu
- Publication Type:Review
- Keywords:
boney metastases;
breakthrough;
cancer;
pain;
triple opioid therapy
- MeSH:
Activities of Daily Living;
Analgesics;
Breakthrough Pain;
Breast;
Cough;
Diphosphonates;
Lifting;
Lung;
Neoplasm Metastasis;
Prostate;
Sneezing;
Steroids;
Stress, Psychological;
Weight-Bearing
- From:The Korean Journal of Pain
2013;26(3):223-241
- CountryRepublic of Korea
- Language:English
-
Abstract:
Boney metastasis may lead to terrible suffering from debilitating pain. The most likely malignancies that spread to bone are prostate, breast, and lung. Painful osseous metastases are typically associated with multiple episodes of breakthrough pain which may occur with activities of daily living, weight bearing, lifting, coughing, and sneezing. Almost half of these breakthrough pain episodes are rapid in onset and short in duration and 44% of episodes are unpredictable. Treatment strategies include: analgesic approaches with "triple opioid therapy", bisphosphonates, chemotherapeutic agents, hormonal therapy, interventional and surgical approaches, steroids, radiation (external beam radiation, radiopharmaceuticals), ablative techniques (radiofrequency ablation, cryoablation), and intrathecal analgesics.
